A heart palpitation is the sensation that your heart has skipped a beat or added an extra beat. It may feel like your heart is racing, pounding, or fluttering. You may become overly aware of your heartbeat. This sensation is sometimes also felt in the neck, throat, or chest. While you are having palpitations, your heart rhythm may or may not be abnormal.
Heart palpitations can be caused by a variety of factors, including caffeine, exercise, smoking, or stress.
Although they can be quite unsettling, most heart palpitations are harmless and resolve on their own without treatment.
Rarely, heart palpitations are a sign of a serious condition. Seek medical attention immediately if your heart palpitations are accompanied by other symptoms such as chest pain, fainting, difficulty breathing, or if you have previously diagnosed heart problems.
Heart palpitations can be caused by a wide variety of things, including:
- strenuous exercise
- caffeine (coffee, tea, chocolate, and cola drinks)
- nicotine from tobacco products such as cigarettes and cigars
- stress, anxiety, fear, or panic
- hormonal changes, including pregnancy
- electrolyte abnormalities
- low blood sugar
- overactive thyroid (hyperthyroidism)
- low levels of oxygen or carbon dioxide in the blood
- blood loss
- over-the-counter medications, including cold and cough medications, herbal supplements, and nutritional supplements
- prescription medications, including beta blockers, asthma inhalers, and decongestants
- illegal drugs such as amphetamines and cocaine
Most heart palpitations are benign (harmless), but they can be a sign of illness when you also have:
- irregular heartbeat or rhythm changes (arrhythmia)
- previously diagnosed heart disease
- heart disease risk factors
- a defective heart valve
Seek medical attention right away if your palpitations are accompanied by:
- dizziness or lightheadedness
- loss of consciousness
- breathing difficulty
- profuse perspiration
- pain, pressure, or tightening in your chest
- pain in your arms, neck, chest, jaw, or upper back
- a resting pulse rate of more than 100 beats per minute
These could be signs of a more serious condition.
The cause of heart palpitations can be very difficult to diagnose, especially if the palpitations don’t occur while you are in the doctor’s office.
Your physician will probably conduct a thorough physical examination to identify a cause. Be prepared to answer questions about your physical activities, stress levels, prescription and over-the-counter medication and supplement use, and previously diagnosed health conditions.
If necessary, your doctor may refer you to a heart specialist (cardiologist). Tests to help rule out certain diseases or heart problems include:
- blood tests
- urine tests
- a stress test
- Holter monitor (a portable machine that records the heart’s rhythm for 24 hours)
- echocardiogram (ultrasound of the heart)
- electrocardiogram (EKG)
- X-ray of the chest
- electrophysiology study (EPS, to check the heart’s electrical function)
- coronary angiography (to check how blood flows through your heart)
Treatment depends on the cause of your palpitations. Any underlying medical conditions will have to be addressed.
Most of the time, no cause for palpitations is found, and no treatment is advised.
If your palpitations are due to controllable lifestyle choices such as smoking or too much caffeine, simply cutting down or eliminating those substances may be all that is needed. If you think medication may be the problem, ask your doctor about alternative medications or treatments.
If your doctor tells you that treatment is not necessary, there are steps you can take to decrease your chance of palpitations:
- Keep a log of your activities, as well as the foods and beverages you eat. Note incidents of heart palpitations. Try to identify your triggers and avoid them.
- If you are anxious or stressed, try relaxation exercises, deep breathing, yoga, tai chi, etc.
- Limit or stop your intake of alcohol and caffeine.
- Don’t smoke or use tobacco products.
- If medication is causing palpitations, ask your doctor if there are any alternatives.
- Exercise regularly.
- Stick to a healthy diet and try to keep blood pressure and cholesterol levels under control.